Differential Diagnosis for Abdominal Pain after Eating

• Single most likely diagnosis
  • Irritable Bowel Syndrome (IBS): This is often the most common cause of abdominal pain after eating, especially if the pain is associated with changes in bowel habits or relieved by defecation. IBS is a functional gastrointestinal disorder characterized by recurrent abdominal pain and changes in bowel movements without an identifiable cause.
• Other Likely diagnoses
  • Gastroesophageal Reflux Disease (GERD): Abdominal pain after eating can be due to GERD, especially if the pain is in the upper abdomen and accompanied by symptoms like heartburn and regurgitation.
  • Peptic Ulcer Disease: Ulcers in the stomach or duodenum can cause abdominal pain that worsens after eating, particularly if the pain is localized to the upper abdomen and improves with eating or worsens a few hours after eating.
  • Food Intolerances (e.g., Lactose Intolerance): Difficulty digesting certain foods can lead to abdominal pain, bloating, and gas after eating those foods.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause abdominal pain after eating, along with diarrhea, weight loss, and sometimes blood in the stool.
• Do Not Miss diagnoses
  • Acute Appendicitis: Although appendicitis typically presents with pain that initially is diffuse or around the navel and then localizes to the lower right abdomen, it can occasionally start after eating. Missing this diagnosis can lead to perforation and severe complications.
  • Mesenteric Ischemia: This condition involves insufficient blood flow to the intestines and can cause severe abdominal pain after eating, along with other symptoms. It is a medical emergency.
  • Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the back, often after eating, especially fatty foods.
• Rare diagnoses
  • Eosinophilic Gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to abdominal pain, nausea, and vomiting after eating.
  • Celiac Disease: An autoimmune reaction to gluten that can cause abdominal pain, diarrhea, and malabsorption after consuming gluten-containing foods.
  • Gastric Cancer: Although rare, gastric cancer can cause abdominal pain after eating, along with weight loss and other symptoms. It's more common in certain populations and with specific risk factors.